{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:48:29Z","timestamp":1789523309255,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T00:00:00Z","timestamp":1658620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>A total of 2.4 million adults in England were dispensed a benzodiazepine or Z\u2010drug (BZRA) in 2017\/18, and more than 250\u2009000 patients in the UK take BZRAs beyond the recommended duration. Deprescribing is a clinician\u2010guided process of withdrawing inappropriate drugs. This review aimed to evaluate the evidence base supporting the feasibility and clinical effectiveness of all forms of deprescribing initiatives used to discontinue long\u2010term (\u2265\u20094\u00a0weeks) BZRAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Systematic review of randomized controlled trials evaluating BZRAs deprescribing among adults in community, primary or outpatient settings. MEDLINE, Embase and PsycINFO were searched from inception to February 2021. Primary outcomes were successful discontinuation in the short (&lt;\u20094\u00a0weeks) or long term (\u2265\u20094\u00a0weeks) and the occurrence of withdrawal symptoms, behavioural or psychological symptoms. Studies were categorized as pharmacological or non\u2010pharmacological supported interventions. Study quality was assessed using the Cochrane risk\u2010of\u2010bias tool. Where appropriate, risk ratios (RRs), mean differences and 95% confidence intervals (CIs) were calculated, and Mantel\u2013Haenszel methods using the random\u2010effect meta\u2010analysis was undertaken to calculate summary effect estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies were included (<jats:italic>n<\/jats:italic>\u2009=\u20091431 participants). Heterogeneity in study design and effect was observed. Benzodiazepines were successfully deprescribed when gradually tapered with non\u2010pharmacological support compared with gradual tapering alone in the short term (<jats:italic>n<\/jats:italic>\u2009=\u2009124; RR\u2009=\u20092.02; 95% CI\u2009=\u20091.41, 2.89) and long term (<jats:italic>n<\/jats:italic>\u2009=\u2009123; RR\u2009=\u20092.45; 95% CI\u2009=\u20091.56, 3.85). Benzodiazepine deprescribing was more successful when supported by non\u2010pharmacological methods versus routine care (<jats:italic>n<\/jats:italic>\u2009=\u2009189; RR\u2009=\u20093.26; 95% CI\u2009=\u20092.36, 4.51). Quality of evidence reporting effectiveness was very low to low.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It may be feasible to deprescribe benzodiazepines depending on the process and support mechanisms employed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15997","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T07:49:17Z","timestamp":1657525757000},"page":"7-16","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Feasibility and effectiveness of deprescribing benzodiazepines and Z\u2010drugs: systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0830-5031","authenticated-orcid":false,"given":"Anisha","family":"Soni","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-4392","authenticated-orcid":false,"given":"Arun","family":"Thiyagarajan","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-7955","authenticated-orcid":false,"given":"Joanne","family":"Reeve","sequence":"additional","affiliation":[{"name":"Academy of Primary Care Hull York Medical School  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,24]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"31","article-title":"Benzodiazepines revisited","volume":"5","author":"Mehdi T","year":"2012","journal-title":"Br J Med Pract"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.yco.0000165594.60434.84"},{"key":"e_1_2_9_4_1","volume-title":"Benzodiazepines: How They Work and How to Withdraw (The Ashton Manual) [internet]","author":"Ashton C","year":"2002"},{"key":"e_1_2_9_5_1","first-page":"728","article-title":"Abuse potential of benzodiazepines","volume":"61","author":"Ciraulo DA","year":"1985","journal-title":"Bull NY Acad Med"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.280.6218.910"},{"key":"e_1_2_9_7_1","volume-title":"British National Formulary (online) [internet]","author":"Joint Formulary Committee","year":"2019"},{"key":"e_1_2_9_8_1","unstructured":"National Institute for Health and Care Excellence.Guidance on the use of zaleplon zolpidem and zopiclone for the short\u2010term management of insomnia (TA77) [internet].2004. 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